摘要
目的 观察头孢噻肟钠联合双歧三联活菌（培菲康）治疗肝硬化自发性细菌性腹膜炎（SBP）的临床疗效和不良反应。方法 选取2013年1月至2015年8月就诊的116例肝硬化SBP患者,将患者随机分为两组。试验组58例用头孢噻肟钠联合培菲康治疗,对照组58例单用头孢噻肟钠治疗,均连续治疗10 d为1个疗程。观察比较两组患者1个疗程后的临床症状、疗效和不良反应。比较3个月时两组患者的病死率。结果 治疗1个疗程后,与对照组比较,试验组治愈率显著提高（62.07%vs 41.38%,χ2=4.971,P〈0.05）,临床总有效率也显著提高（96.55%vs 70.69%,χ2=14.162,P〈0.01）。试验组治疗1个疗程后血清丙氨酸氨基转移酶（ALT）和总胆红素（TBIL）水平明显下降（P均〈0.01）,并恢复至正常范围;对照组治疗后ALT值、TBIL水平亦明显下降（P均〈0.05）,但未恢复至正常范围。不良反应（头痛眩晕、胃肠道反应、上消化道出血、低血压休克、肝功能衰竭）发生率试验组均稍低于对照组,但差异均无统计学意义（P均〉0.05）;肝性脑病发生率试验组明显较对照组降低（20.69%vs 37.93%,χ2=4.161,P〈0.05）。治疗3个月后,试验组有3例死亡（5.17%）,对照组9例死亡（15.52%）,试验组患者病死率较对照组有所降低,但差异无统计学意义（χ2=3.346,P〉0.05）。结论 头孢噻肟钠联合培菲康治疗肝硬化SBP能有效缓解患者的临床症状,提高临床疗效,安全性高,不良反应少。
Objective To observe the clinical effect and the side effects of cefotaxime sodium combined with bifid triple viable（Bifico） for the treatment of spontaneous bacterial peritonitis（SBP） in liver cirrhosis patients. Methods A total of 116 patients with SBP in liver cirrhosis patients treated in Xi＇an No. 4 Hospital from January 2013 to August 2015 were ran- domly divided into experiment group and control group （n = 58 each）. Cefotaxime sodium combined with bifid triple viable were given in experiment group, and cefotaxime sodium alone was given in control group. One course of treatment was 10 days in both two groups. The clinical symptoms, therapeutic effects and adverse reactions were observed after 1 course of treatment, and the mortality at 3-month after treatment was compared between two groups. Results After one course of treatment, the cure rate and the clinical total effective rate in experiment group were respectively higher than those in con- trol group（62. 07% vs 41.38% ,X2 =4. 971 ,P 〈 0. 05 ;96. 55% vs 70. 69% ,X2 = 14. 162 ,P 〈 0. 01 ）. After one course of treatment, the levels of serum alanine aminotransferase （ALT） and total bilirubin （TBIL） in experiment group significantly decreased compared with pre-treatment （all P 〈 0, 01 ） and returned to normal range, and the levels of serum ALT and TBIL in control group also statistically decreased compared with pre-treatment （ P 〈 0. 05 ）, but did not return to normal range. The incidences of adverse reactions including headache and dizziness, gastrointestinal reaction, hemorrhage of upper digestive tract, low blood pressure or shock and liver function failure in experiment group were slightly lower those in control group, but there were no statistical differences in them between two groups. The incidence of hepatic encephalopathy in experiment group was significantly lower than that in control group （ 20. 69% vs 37.93% ,X2 =4. 161 ,P 〈0. 05）. At 3-month after treatment,3 cases died（5.17% ） in experiment group,and 9 cases died in control group（ 15.52% ）. The mortality in experiment group was somewhat lower than that in control group, but there was no significant difference between two groups （X2 = 3. 346, P 〉 0. 05 ）. Conclusion The combined treatment of cefotaxime sodium and bifid triple viable ean effectively relieve clinical symptoms of SBP and improve clinical efficacy with higher safety and less adverse reactions.
出处
《中国临床研究》
CAS
2016年第9期1185-1188,共4页
Chinese Journal of Clinical Research
基金
国家自然科学基金(81070328)
关键词
头孢噻肟钠
培菲康
肝硬化
自发性细菌性腹膜炎
不良反应
Cefotaxime sodium
Bifid triple viable
Liver cirrhosis
Spontaneous bacterial peritonitis
Adverse reactions
